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J Am Acad Psychiatry Law 33:4:529-534 (2005)
Copyright © 2005 by the American Academy of Psychiatry and the Law.
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ANALYSIS AND COMMENTARY

The Shift of Psychiatric Inpatient Care From Hospitals to Jails and Prisons

H. Richard Lamb, MD and Linda E. Weinberger, PhD

Dr. Lamb is Professor of Psychiatry and Director, Division of Psychiatry, Law, and Public Policy, and Dr. Weinberger is Professor of Clinical Psychiatry and Chief Psychologist, Institute of Psychiatry, Law, and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California. Address correspondence to: H. Richard Lamb, MD, USC Institute of Psychiatry, Law, and Behavioral Science, PO Box 86125, Los Angeles, CA 90086-0125. E-mail: hlamb{at}usc.edu

Far-reaching structural changes have been made in the mental health system. Many severely mentally ill persons who come to the attention of law enforcement now receive their inpatient treatment in jails and prisons, at least in part, because of a dramatic reduction of psychiatric inpatient beds. While more high-quality community treatment, such as intensive case management and assertive community treatment, is needed, the authors believe that for many, 24-hour structured care is needed in the mental health system for various lengths of time to decrease criminalization. Another central theme of this article is that when a mentally ill individual is arrested, that person now has a computerized criminal record, which is easily accessed by the police and the courts in subsequent encounters. This may influence their decisions and reinforce the tendency to choose the criminal justice system over the mental health system.




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Copyright © 2005 by the American Academy of Psychiatry and the Law.